This is a fully remote position, open to applicants in Canada.

📋 Description

• Document patient interactions and update case records in pharmacy systems while adhering to privacy regulations.

• Handle prior authorization requests by gathering clinical documentation, completing payer-specific forms, submitting requests, and monitoring their status.

• Confirm insurance coverage, review patient insurance cards and formulary details, and log coverage information.

• Assist with financial aid enrollment by collecting eligibility data and completing manufacturer copay applications.

• Facilitate specialty pharmacy referrals by processing forms, verifying insurance benefits, scheduling patient communications, and coordinating with specialty pharmacy teams.

• Address routine patient inquiries, provide status updates, answer basic questions using scripts, and escalate complex issues as necessary.

• Monitor pending prior authorizations, follow up with payers, and inform senior staff of any delays or denials.

⛳️ Requirements

• High School Diploma/GED or equivalent experience is mandatory.

• A minimum of 3 years of experience in pharmacy support, prior authorization processing, insurance verification, or healthcare administrative roles is required.

• Completion of Health Insurance Portability and Accountability Act (HIPAA) or relevant compliance training is necessary.

• An Associate's degree in healthcare administration, life sciences, pharmacy technology, or a related field, or equivalent experience is preferred.